How is my wife doing based upon these two screenshots from OSCAR

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Jeffj318
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How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Tue Mar 30, 2021 4:21 pm

My wife (Michele) is a newbie CPAP user. She also has Stage 4 cancer so is tackling both cancer and the new CPAP (APAP really) regime.
I had attempted to follow regulations and posted under a former post, however, did not receive any responses so my apologies for starting fresh I guess.
Hopefully, I have attached the screenshots correctly. I know there are a lot of experts on this forum because they have helped us tremendously already.
Thanking all (kudos to Pugsy) for the invaluable help. - Jeff
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Resmed Airsense 10 For Her
Phillips Dreamwear nasal cushion mask
My wife is the CPAP user.

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ChicagoGranny
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by ChicagoGranny » Tue Mar 30, 2021 5:04 pm

She's doing very well. AHI less than 1.0, only minor leaks.

How does she like that starting (min) pressure? Does she feel like she is getting enough air starting out? Notice it doesn't spend much time there and ramps up quickly to 9+. If it were my therapy, I would change the min to 9.0. But, if she's happy, leave it as is.

Keep an eye on the leak line in case the mask headgear starts to stretch out or gets out of adjustment.

Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Tue Mar 30, 2021 7:28 pm

Thank you, Granny. Your answers have helped.
Her pulmonologist just started everything on a generic basis. A ramp of 4, etc.
After reading much on this forum, I stopped the ramp and changed the pressure to 5, and then inched up to 5.6.
She said she seems fine starting at that pressure, however, maybe we will move up to 6 at least and see how that goes.

So, March 29 was okay for leaks? I thought I heard a lot of "wind noise" early this morning.
She has done very well adjusting and actually wants to use the Airsense 10 as she said she sleeps so much better and through the night.

How often would you suggest changing out the nasal cushions on the Dreamwear mask?
I am working on getting supplies via a DME and Medicare since we paid out of pocket for the Airsense 10 For Her.
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ChicagoGranny
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by ChicagoGranny » Wed Mar 31, 2021 2:16 pm

Jeffj318 wrote:
Tue Mar 30, 2021 7:28 pm
She said she seems fine starting at that pressure, however, maybe we will move up to 6 at least and see how that goes.
Yep, we do a lot of trial and error to get CPAP optimized.
Jeffj318 wrote:
Tue Mar 30, 2021 7:28 pm
So, March 29 was okay for leaks? I thought I heard a lot of "wind noise" early this morning.
The machine will maintain therapeutic pressure under unintentional leak levels of 30 or so. Of course, we don't want airflow into the eyes causing dryness. I wonder if she had rolled into a different position shortly after six and the pillows were not square in the nostrils. Generally, those Dreamwear pillows can achieve zero leaks. You might want to find the mask on youtube and watch three or four videos on fitting and adjusting.
Jeffj318 wrote:
Tue Mar 30, 2021 7:28 pm
How often would you suggest changing out the nasal cushions on the Dreamwear mask?
I use masks for a very long time - my current mask is 7 months old. Your wife's experience may differ.

Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Wed Mar 31, 2021 4:33 pm

Thanks for all the tips!

She is wearing the nasal cushion mask after trying the pillows and not caring for the in or near the nostrils.
As long as the AHI's are good, I guess she is good to go at this time?
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Miss Emerita
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Miss Emerita » Wed Mar 31, 2021 6:55 pm

Is she feeling well rested during the day using the machine? This is a critical datum, even though it is subjective. I realize this may not be easy to say if she’s having treatment for the cancer that cause her to feel sleepy, tired, or depleted during the day.
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zonker
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by zonker » Wed Mar 31, 2021 10:09 pm

Miss Emerita wrote:
Wed Mar 31, 2021 6:55 pm
Is she feeling well rested during the day using the machine? This is a critical datum, even though it is subjective. I realize this may not be easy to say if she’s having treatment for the cancer that cause her to feel sleepy, tired, or depleted during the day.
+1
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ChicagoGranny
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by ChicagoGranny » Thu Apr 01, 2021 7:25 am

Miss Emerita wrote:
Wed Mar 31, 2021 6:55 pm
Is she feeling well rested during the day using the machine? This is a critical datum, even though it is subjective. I realize this may not be easy to say if she’s having treatment for the cancer that cause her to feel sleepy, tired, or depleted during the day.
I took this as the sign you are looking for -
She has done very well adjusting and actually wants to use the Airsense 10 as she said she sleeps so much better and through the night.

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Miss Emerita
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Miss Emerita » Thu Apr 01, 2021 10:48 am

Thanks, Granny. Actually I'm also interested in the daytime experience. I'm wondering whether it'd make sense to recommend the introduction of some EPR, given the considerable flow limitation. If both night and day are good, I'd say leave well enough alone. But if even with 10.5 hours of sleep, the daytime is not so great, some EPR might help.
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Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Thu Apr 01, 2021 11:55 am

Thanks, ladies, for joining in with the conversation. Just having Stage 4 cancer alone is overwhelming and adding in CPAP therapy just tops it off.

All that said, Michele truly enjoys using the Airsense 10 with the cushion mask. She even uses it when she takes a nap during the day which is usually every day due to the effects of chemo.
The CPAP therapy certainly seems to help her sleep better although sometimes nausea can creep in on some occasions especially the night of chemo. She is taking meds for that though which normally help.

Since she receives maintenance chemo and is a senior, she remains tired somewhat during the day no matter what.

Her breathing sounds good. She has more restful nights for sure and no snoring, sounds, or leg jerks. There are many nights where she will sleep all the way through which was never the case before CPAP therapy. I will probably tweak the starting pressure based upon what Granny was pointing out and see if she likes that any better or can tell a difference.
Thanks again for the great responses. I will stick with this post for further follow-up.
Resmed Airsense 10 For Her
Phillips Dreamwear nasal cushion mask
My wife is the CPAP user.

Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Sun Jul 18, 2021 1:09 pm

Hello and good day!

I can load up a screenshot or two from OSCAR, however, I wanted to start simple.
Michele has been having mask leaks based on the MyAir app.
Last night was 14/20. Friday 12/20, Thursday 17/20, Wednesday 10/20, Tuesday 18/20, and Monday 18/20.

All that said, her AHI events are always below 1. Last night was 0.1 and usually very low. 0.8, 0.6, 0.3, and so forth.
Does her mask leak matter if the AHI is always below 1?

She changes her nasal cushion every two weeks and recently got a new headgear.
She sleeps through the night. Last night and some other nights I can hear what I call the "wind tunnel." It sounds like rushing wind and can last for 10-15 minutes.
Sometimes, she will be sleeping on her side. I am wondering if that is blocking some of the air coming down the sides of the headgear.

If you need to see an OSCAR screenshot or two let me know and I will upload it.
Thanks!
Resmed Airsense 10 For Her
Phillips Dreamwear nasal cushion mask
My wife is the CPAP user.

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Pugsy
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Pugsy » Sun Jul 18, 2021 1:28 pm

Jeffj318 wrote:
Sun Jul 18, 2021 1:09 pm
Does her mask leak matter if the AHI is always below 1?
Well......at all depends on just how bad of a large leak she is having.
MyAir only tells you it went over the red line of 24 L/min enough to make note but it doesn't tell you how deep into large leak territory.
The deeper your go the more chance of that nice low AHI being low because events happened but the machine didn't know they happened because deep into large leak territory the machine can't sense or record optimally.

The reason we keep an eye out on leak numbers is we want a nice low AHI coming from not much happening and not the machine being clueless and missing a truck load of apneas.

Pick the worst OSCAR detailed report in terms of leaks and lets see if the worst is really all that problematic or not.
A little bit over 24 L/min isn't a big deal but way over 24 L/min and spending much time there is potentially a problem.
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Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Sun Jul 18, 2021 5:50 pm

I took three screenshots. One is from Saturday, one from Friday, and one (low leak) from Thursday.
Pugsy (or others) let me know what you think. My wife really loves the Dreamwear headgear and nasal mask.
She tried the pillows and did not like them.
My wife, as you have read, has Stage 4 cancer so she is not interested in any of this CPAP stuff and relies on me.
She sleeps through the night and does not need to take an afternoon nap as she used to do.
She is still being treated for cancer, however, no chemo at this time which also helps with not being as tired.
Thanks for all your help. This group is the best!
Attachments
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Low leak
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Higher leaks
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screenshot-20210718-193334 07.17.21.png
Higher leaks
screenshot-20210718-193334 07.17.21.png (98.21 KiB) Viewed 696 times
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My wife is the CPAP user.

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Pugsy
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Pugsy » Sun Jul 18, 2021 6:09 pm

I wouldn't worry about those leaks as long as she's sleeping well.
The worst of the big leak was around 35 L/min and really not all that prolonged in duration.
If she spent half the night up around 40 or 50 L/min...different discussion.
Some nights the leak graph is a bit ugly and sometimes not so ugly. It happens, masks move or we open our mouths sometimes.

Even the worst night was only 17% of the night in large leak and the worst was some very brief spikes to around 40 L/min.
One chunk of about an hour at around 30 L/min.

If you start seeing a lot of UA flagged events then we worry but I imagine the nice low AHI is because not much is happening.
She's just not spending all that much time way deep into large leak territory to be missing events and we would expect to see some UA flags first.

She still got Mr Smiley for leak management control because you don't see Mr Frowny until 30% or more of the night is spent above 24 L/min. MyAir dings you on "scores" for the least little thing. I would ignore the scores. Important thing is she is sleeping good.
A little time in large leak territory isn't the end of the world despite the "score" from MyAir.
That whole scoring system is a bit sophomoric IMHO anyway.
How she is sleeping and feeling is much more important than getting a good math score.

BTW....I often have worse leak graphs myself. :lol: :lol: I sleep through the leaks so I just shrug my shoulders and move on.
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zonker
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by zonker » Sun Jul 18, 2021 6:20 pm

Pugsy wrote:
Sun Jul 18, 2021 6:09 pm
I wouldn't worry about those leaks as long as she's sleeping well.
<snip>
How she is sleeping and feeling is much more important than getting a good math score.
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the two great unwritten rules of life are-
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2.
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